OBJECTIVES: Drugs with anticholinergic properties are associated with central and peripheral adverse effects in the elderly. The purpose of this study was to determine the prevalence and predictors of inappropriate anticholinergic medication use among the elderly as per 2012 American Geriatrics Society (AGS) Beers’ criteria. METHODS: A retrospective cross-sectional study design was conducted using 2009-2010 Medical Expenditure Panel Survey (MEPS). The study sample included individuals aged ≥65 years. Inappropriate anticholinergic drugs were identified using the MEPS prescription files. Weighted descriptive statistics were used to estimate the prevalence of inappropriate anticholinergic medication use in elderly patients. Multivariable logistic regression within the conceptual framework of Anderson Behavioral Model was used to identify predictors associated with the use of inappropriate anticholinergic medications in the elderly. RESULTS: Analysis of the 2009-2010 MEPS data revealed that an estimated 78.6 million members of the US population were elderly. (12.78%) It was estimated that 7.51 million (95% CI: 6.64 to 8.38) of elderly individuals used potentially inappropriate anticholinergic medications, resulting in an overall prevalence of 9.56%. The most frequently used inappropriate anticholinergics were cyclobenzaprine (2.08%), promethazine (1.75%), amitriptyline (1.47%), hydroxyzine (0.95%), and dicyclomine (0.84%). Multivariable analyses revealed that female gender (OR: 1.37; 95% CI: 1.06-1.77), South region (OR: 1.88; 95% CI: 1.25-2.84) and anxiety disorder (OR: 2.15; 95% CI: 1.57-2.94) increased the likelihood of receiving inappropriate anticholinergic medications; whereas age between 75 to 84 years (OR: 0.64; 95% CI: 0.49-0.85), age >=85 years (OR: 0.52; 95% CI: 0.33-0.81) and >15 years of education (OR: 0.54; 95% CI: 0.35-0.84) decreased the likelihood of receiving inappropriate anticholinergic medications. CONCLUSIONS: The study found that approximately one in ten elderly patients used inappropriate anticholinergic medications. Several predisposing and need factors were associated with the use of inappropriate anticholinergic medications. Efforts are needed to improve inappropriate prescribing practices to optimize medication use in the elderly.